Medical or health care services are traditionally rendered by numerous providers who operate independently of one another. Providers may include, for example, hospitals, clinics, doctors, therapists and diagnostic laboratories. A single patient may obtain the services of a number of these providers when being treated for a particular illness or injury. Over the course of a lifetime, a patient may receive the services of a large number of providers. Each medical service provider typically maintains medical records for services the provider renders for a patient, but rarely if ever has medical records generated by other providers. Such documents may include, for example, new patient information or admission records, doctors' notes, and lab and test results. Each provider will identify a patient with a medical record number (MRN) of its own choosing to track medical records the provider generates in connection with the patient.
Due to increasing costs, providers are being grouped by insurance companies, hospitals and other organizations and are setting up formal networks of medical service providers. Medical service providers are joining these networks or organizations in order to compete for patients. The networks typically negotiate fixed prices for medical services and supplies. Furthermore, the networks manage the services dispensed by developing sets of standard practice rules and managing referrals to specialists to insure that specialty services are medically necessary.
In order to make health care management more efficient, improve the quality of health care delivered and eliminate inefficiencies in the delivery of the services, there is a desire to collect all of a patient's medical records into a central location for access by health care managers and providers. A central database of medical information about its patients enables a network or organization to determine and set practices that help to reduce costs. It also fosters sharing of information between health care providers about specific patients that will tend to improve the quality of health care delivered to the patients and reduce duplication of services.
There are several impediments to centralizing and sharing medical records. First, there is the cost in equipment, software and personnel required to collect and process medical records at a central location, and in responding to requests for medical records. Medical records present special problems due to their diversity in form and content. In order to efficiently process the medical records for subsequent access, standardized procedures, forms and reporting must be developed and adopted by the entire network of providers. Second, there is the cost and reluctance of the independent medical service providers in conforming to standardized practices typically required for a central record keeping system. Since most medical service providers have preexisting or "native" record keeping systems, these would have to be converted and a unique medical record number or patient identifier assigned to each patient. Standardizing medical record keeping, including unique patient identifiers within a network, may, however, be complicated by the loose and fluid nature of such networks. A provider may be member of several networks. Medical service providers are constantly added and dropped from networks and health care organizations, or parts thereof, may merge or split apart. Thus, a provider would not only have to keep multiple identifiers, the provider would also be further burdened with additional and changing standards. Providers are unlikely to have the resources and expertise to accommodate the requirements of changing or multiple networks.